Dr. Donnica: Hidradenitus Supperativa (HS) has been called by many other
names including "acne inversa," but it is not well known among patients
or physicians. Its name describes its appearance: oozing, inflamed sweat glands.
This sometimes debilitating autoimmune disorder appears as severe, recurrent boils.
Unfortunately, it can often take up to 10 years to diagnose this condition correctly
because of limited awareness by healthcare professionals and extreme embarrassment
from the nearly one million Americans who suffer from it. Of even greater concern
is that its cause is unknown, there is no known consistently effective treatment,
and no major research effort under way to aggressively seek a cure.

HS is a non-contagious, recurrent skin disease usually found in areas of the
body where there is skin-to-skin contact (such as armpits, groin, thighs, and
under breasts) and around hair follicles where apocrine sweat glands are located.
Characteristically, it progresses from boils or abscesses to hard lumps and
painful, rounded deep-seated inflamed lesions with subsequent scarring and chronic
seepage (aka suppuration). These hard lumps occur under the skin and may grow
as large as baseballs. In many cases, they are very painful and may persist
for years with or without recurrent inflammation. Inflamed lumps may lead to
extensive drainage, which may cause the development of sinus tracts under the
skin. These may heal slowly or not at all, which may lead to further inflammation
and lumps. Bacterial infections are possible at these sites. Draining the lumps
may provide some pain relief, but the lumps and tracts often recur.

Because HS may be extremely painful and the drainage may have a foul odor,
sufferers often limit their activities including work or even going out in public.
As a result, HS sufferers often suffer from depression as well.